In 2016, five U.S. states and a group of religious health care companies sued the federal government over Rule 1557 of the Affordable Care Act (ACA, aka. Obamacare), a rule requiring all federally-funded healthcare providers and insurers to provide treatment and coverage regardless of sex or gender identity.

The rule required religious employers and healthcare facilities to cover transgender-related care as well as reproductive healthcare like contraceptives and abortions, but it could be overturned depending on what Donald Trump’s Department of Justice (DOJ) does next.

In the aforementioned lawsuit, known as Franciscan Alliance v. Price, the religious healthcare organization won and, according to thehill.com, “a Texas district court judge issued a nationwide injunction blocking” Rule 1557.

The judge’s ruling came at the end of 2016, and Trump’s Department of Health and Human Services (HHS) decided not to appeal the ruling. However, Trump’s DOJ, which represented HHS in the lawsuit, said that it would review a newly proposed rule which could potentially rollback the ACA’s protections for anyone needing transgender and reproductive healthcare.

Though the newly proposed rule is not publicly available, it has reportedly already cleared HHS. After the DOJ’s review is complete — something which could take several more weeks or months — the federal Office of Management and Budget would review the rule, release it for a public comment period and then possibly incorporate it into laws governing the ACA’s application

Naturally, religious healthcare providers say that Rule 1557 requires them to provide treatments that violate their religious beliefs. Supporters of Rule 1557 say that it enshrines long-needed protections for trans and reproductive healthcare.

Mara Keisling, Executive Director of the National Center for Transgender Equality, said, “The Section 1557 regulation has been literally life-saving for transgender people all across the country, who are routinely turned away from emergency rooms and doctors’ offices and refused coverage for critical medical care.”

Keisling continued:

“The administration is rejecting the views of every major medical associations, most courts, and most Americans, who believe that people should not be denied health care because of who they are. That’s not just bad science and bad law — it’s a dangerous attack on transgender people’s ability to survive.”